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Acute Kidney Injury

Medically reviewed by Last updated on Jul 4, 2022.

What is acute kidney injury?

Acute kidney injury (AKI) is also called acute kidney failure, or acute renal failure. AKI happens when your kidneys suddenly stop working correctly. Normally, the kidneys remove fluid, chemicals, and waste from your blood. These wastes are turned into urine by your kidneys. AKI usually happens over hours or days. When you have AKI, your kidneys do not remove the waste, chemicals, or extra fluid from your body. A normal amount of urine is not produced. AKI is usually temporary, but it may become a chronic kidney condition.

What causes AKI?

  • Decreased blood flow to the kidney, such as from hypercalcemia (high blood calcium level) or severe heart disease
  • A disease or condition that affects the kidneys, such as hypertension (high blood pressure) or diabetes
  • A blockage in the kidney or ureter, such as a kidney or bladder stone, enlarged prostate, or tumor

What increases my risk for AKI?

  • Being hospitalized with a serious illness, such as sepsis or severe burns
  • Peripheral artery disease
  • Older age in adults
  • Kidney or liver diseases
  • Medical conditions such as dehydration, hypertension, diabetes, or heart failure
  • Certain medicines such as NSAIDs

What are the signs and symptoms of AKI?

You may not have any symptoms with early or mild AKI. As AKI progresses, you may have any of the following:

  • Decrease in the amount of urine or no urination
  • Swelling in your arms, legs, or feet
  • Weakness, drowsiness, or no appetite
  • Nausea, flank pain, muscle twitching or muscle cramps
  • Itchy skin, or your breath or body smells like urine
  • Behavior changes, confusion, disorientation, or seizures

How is AKI diagnosed?

There are many causes of AKI. To find the cause and to treat your AKI correctly, your healthcare provider may do any of the following:

  • Blood and urine tests show how well your kidneys are working. They may also show the cause of your AKI.
  • An x-ray or ultrasound may show problems with your kidneys. Your healthcare provider may see a blockage in your kidneys. He or she may see narrowing of the artery that sends blood to your kidneys. You may be given contrast liquid to help your kidneys show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is AKI treated?

Treatment depends upon the cause of your acute kidney injury and how severe it is. Usually, AKI will be monitored in the hospital. If you have mild AKI, you may be able to go home to recover. Your healthcare providers will treat the cause of your AKI. You may need IV fluids if your AKI was caused by little or no fluid in your body. You may need dialysis to remove waste and extra fluid from your body. Your healthcare provider may tell you to eat food low in sodium (salt), potassium, phosphorus, or protein. You may need to see a dietitian before you are discharged to get help with planning your meals.

How can I prevent AKI?

  • Manage other health conditions such as diabetes, high blood pressure, or heart disease. These conditions increase your risk for acute kidney injury. Take your medicines for these conditions as directed. Also, monitor your blood sugar and blood pressure levels as directed. Contact your healthcare provider if your levels are not in the range he or she says it should be.
  • Talk to your healthcare provider before you take over-the-counter-medicine. NSAIDs, stomach medicine, or laxatives may harm your kidneys and increase your risk for acute kidney injury. If it is okay to take the medicine, follow the directions on the package. Do not take more than directed.
  • Tell healthcare providers if you have had AKI before you get contrast liquid for an x-ray or CT scan. Your healthcare provider may give you medicine to prevent kidney problems caused by the liquid.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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